The Monitor Tech is an unlicensed person who performs indirect care in the department setting. Monitors cardiac rhythms via direct cardiac monitors. Meets the communication needs of the department. Transcribes physician orders in the absence of CPOE and EMR clinical documentation system. Verifies that lab tests and radiology tests have been ordered and done. Prepares and compiles records in Med/ Surg/ Telemetry. Orders supplies for the unit and prepares and completes each patient's chart for necessary forms needed on a daily basis. Able to assist nursing staff with indirect patient care duties as long as the activity does not distract from primary responsibility for dysrhythmia monitoring. *Note: May provide direct patient care under the direct supervision of the RN within scope of Certified Nursing Assistant if 1) possesses active CNA certification; 2) demonstrates annual competency in CNA duties and skills and 3) is relieved of Monitor Technician duties during the time of assisting the RN.
The Patient Account Registrar interviews the patient or his/her representative to obtain patient demographics. This position also secures insurance information, eligibility, benefits and authorizations as applicable. Works closely with all facets of the Admitting department including PBX operator function and reception areas. Must be able to operate a computer to input and retrieve data. Ability to communicate with the population served, utilizing age specific techniques from neonatal, pediatrics, adolescents, young adults, middle adult to geriatrics. Maintain proficiency in medical terminology. Special projects or other assignments may be given with expectations to be completed in a specified timeframe.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care in Telemetry Unit. The Registered Nurse is directly responsible and accountable for the care given to their assigned patients. They communicate with the physician about changes in the patient’s clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Director of Human Resources formulates and supervises programs relative to selection, training, promotion, welfare, and other employer/employee relationships. Interviews job applicants; develops personnel record forms; adjust disputes and grievances and recommends necessary disciplinary actions; analyzes, classifies and evaluates jobs. Administers employee welfare and recreation services, and serves as an adviser to executive staff in personnel implications of policies, programs, and proposed organization changes.
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The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care in Telemetry Unit. The Registered Nurse is directly responsible and accountable for the care given to their assigned patients. They communicate with the physician about changes in the patient’s clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care in Telemetry Unit. The Registered Nurse is directly responsible and accountable for the care given to their assigned patients. They communicate with the physician about changes in the patient’s clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care in Telemetry Unit. The Registered Nurse is directly responsible and accountable for the care given to their assigned patients. They communicate with the physician about changes in the patient’s clinical condition including cardiac monitoring, results of diagnostic studies and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment.
The Monitor Tech is an unlicensed person who performs indirect care in the department setting. Monitors cardiac rhythms via direct cardiac monitors. Meets the communication needs of the department. Transcribes physician orders in the absence of CPOE and EMR clinical documentation system. Verifies that lab tests and radiology tests have been ordered and done. Prepares and compiles records in Med/ Surg/ Telemetry. Orders supplies for the unit and prepares and completes each patient's chart for necessary forms needed on a daily basis. Able to assist nursing staff with indirect patient care duties as long as the activity does not distract from primary responsibility for dysrhythmia monitoring. *Note: May provide direct patient care under the direct supervision of the RN within scope of Certified Nursing Assistant if 1) possesses active CNA certification; 2) demonstrates annual competency in CNA duties and skills and 3) is relieved of Monitor Technician duties during the time of assisting the RN.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of care in the ICU. The Registered Nurse is directly responsible and accountable for the care given to his/her assigned patients. They communicate with the physician about changes in the patient’s clinical condition including hemodynamic monitoring, results of diagnostic studies and abnormal results and symptomatology. Is able to respond quickly and accurately to changes in condition and/or response to treatment. Maintains patient privacy and confidentiality.
The Clinical Supervisor supports administrative responsibility for the department service functions and works collaboratively with the unit Director and/or Manager. In the absence of the unit Director and/or Manager, the Clinical Supervisor may assume the administrative scope of the unit assigned. Develops and implements departmental plans, including performance improvement activities and compliance with current federal and/or state regulations. The Clinical Supervisor prepares, conducts and/or oversees department(s) orientation and training of personnel. Communicates with staff, physicians, and administration both written and verbally. The Clinical Supervisor is responsible and accountable for the quality of staff and functions during their shift. Assists the Department Director in the daily operation of the unit, directing, supervising, and evaluating personnel, ensuring the proper use of time, equipment, and staff. Ensure the efficient functions of the department. Performs direct patient care, only as needed, within the scope practice. Continually assess care and direct staff to make immediate changes in the plan of care.
The Monitor Tech is an unlicensed person who performs indirect care in the department setting. Monitors cardiac rhythms via direct cardiac monitors. Meets the communication needs of the department. Transcribes physician orders in the absence of CPOE and EMR clinical documentation system. Verifies that lab tests and radiology tests have been ordered and done. Prepares and compiles records in Med/ Surg/ Telemetry. Orders supplies for the unit and prepares and completes each patient's chart for necessary forms needed on a daily basis. Able to assist nursing staff with indirect patient care duties as long as the activity does not distract from primary responsibility for dysrhythmia monitoring. *Note: May provide direct patient care under the direct supervision of the RN within scope of Certified Nursing Assistant if 1) possesses active CNA certification; 2) demonstrates annual competency in CNA duties and skills and 3) is relieved of Monitor Technician duties during the time of assisting the RN.
The Monitor Tech is an unlicensed person who performs indirect care in the department setting. Monitors cardiac rhythms via direct cardiac monitors. Meets the communication needs of the department. Transcribes physician orders in the absence of CPOE and EMR clinical documentation system. Verifies that lab tests and radiology tests have been ordered and done. Prepares and compiles records in Med/ Surg/ Telemetry. Orders supplies for the unit and prepares and completes each patient's chart for necessary forms needed on a daily basis. Able to assist nursing staff with indirect patient care duties as long as the activity does not distract from primary responsibility for dysrhythmia monitoring. *Note: May provide direct patient care under the direct supervision of the RN within scope of Certified Nursing Assistant if 1) possesses active CNA certification; 2) demonstrates annual competency in CNA duties and skills and 3) is relieved of Monitor Technician duties during the time of assisting the RN.
Performs security services, including electronic surveillance, and systematic manual Security Officers' rounds. Coordinates facility response to various potential problems for patients, employees, and visitors. Enforces policy & procedure, ensuring equitable enforcement. Follows guidelines and perpetual monitoring techniques, towards establishing a safe workplace for employees and a safe environment of care. Works with the Environment of Care committee to ensure a multi-disciplinary approach to security and safety. Participates in employee awareness and education. Driving as needed for company business.
Performs security services, including electronic surveillance, and systematic manual Security Officers' rounds. Coordinates facility response to various potential problems for patients, employees, and visitors. Enforces policy & procedure, ensuring equitable enforcement. Follows guidelines and perpetual monitoring techniques, towards establishing a safe workplace for employees and a safe environment of care. Works with the Environment of Care committee to ensure a multi-disciplinary approach to security and safety. Participates in employee awareness and education. Driving as needed for company business.
Performs security services, including electronic surveillance, and systematic manual Security Officers' rounds. Coordinates facility response to various potential problems for patients, employees, and visitors. Enforces policy & procedure, ensuring equitable enforcement. Follows guidelines and perpetual monitoring techniques, towards establishing a safe workplace for employees and a safe environment of care. Works with the Environment of Care committee to ensure a multi-disciplinary approach to security and safety. Participates in employee awareness and education. Driving as needed for company business.
Performs security services, including electronic surveillance, and systematic manual Security Officers' rounds. Coordinates facility response to various potential problems for patients, employees, and visitors. Enforces policy & procedure, ensuring equitable enforcement. Follows guidelines and perpetual monitoring techniques, towards establishing a safe workplace for employees and a safe environment of care. Works with the Environment of Care committee to ensure a multi-disciplinary approach to security and safety. Participates in employee awareness and education. Driving as needed for company business.
The Monitor Tech is an unlicensed person who performs indirect care in the department setting. Monitors cardiac rhythms via direct cardiac monitors. Meets the communication needs of the department. Transcribes physician orders in the absence of CPOE and EMR clinical documentation system. Verifies that lab tests and radiology tests have been ordered and done. Prepares and compiles records in Med/ Surg/ Telemetry. Orders supplies for the unit and prepares and completes each patient's chart for necessary forms needed on a daily basis. Able to assist nursing staff with indirect patient care duties as long as the activity does not distract from primary responsibility for dysrhythmia monitoring. *Note: May provide direct patient care under the direct supervision of the RN within scope of Certified Nursing Assistant if 1) possesses active CNA certification; 2) demonstrates annual competency in CNA duties and skills and 3) is relieved of Monitor Technician duties during the time of assisting the RN.
The Monitor Tech is an unlicensed person who performs indirect care in the department setting. Monitors cardiac rhythms via direct cardiac monitors. Meets the communication needs of the department. Transcribes physician orders in the absence of CPOE and EMR clinical documentation system. Verifies that lab tests and radiology tests have been ordered and done. Prepares and compiles records in Med/ Surg/ Telemetry. Orders supplies for the unit and prepares and completes each patient's chart for necessary forms needed on a daily basis. Able to assist nursing staff with indirect patient care duties as long as the activity does not distract from primary responsibility for dysrhythmia monitoring. *Note: May provide direct patient care under the direct supervision of the RN within scope of Certified Nursing Assistant if 1) possesses active CNA certification; 2) demonstrates annual competency in CNA duties and skills and 3) is relieved of Monitor Technician duties during the time of assisting the RN.
The Monitor Tech is an unlicensed person who performs indirect care in the department setting. Monitors cardiac rhythms via direct cardiac monitors. Meets the communication needs of the department. Transcribes physician orders in the absence of CPOE and EMR clinical documentation system. Verifies that lab tests and radiology tests have been ordered and done. Prepares and compiles records in Med/ Surg/ Telemetry. Orders supplies for the unit and prepares and completes each patient's chart for necessary forms needed on a daily basis. Able to assist nursing staff with indirect patient care duties as long as the activity does not distract from primary responsibility for dysrhythmia monitoring. *Note: May provide direct patient care under the direct supervision of the RN within scope of Certified Nursing Assistant if 1) possesses active CNA certification; 2) demonstrates annual competency in CNA duties and skills and 3) is relieved of Monitor Technician duties during the time of assisting the RN.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of professional nursing care in Telemetry. The Registered Nurse is directly responsible and accountable for the care given to his/her patients in the Emergency Department. They communicate with the physician about the changes in the patient’s clinical condition including results of the diagnostic studies and symptomatology. Is capable of responding quickly and accurately to changes in the condition and/or response to treatment. Is knowledgeable about EMTALA regulations and reporting of child/adult abuse to appropriate agencies and Hospital Social Worker. Maintains patient privacy and confidentiality.
The Emergency Department (ED) Charge Nurse is responsible and accountable to the Department Director for the quality of nursing staff and the delivery of patient care during their shift and assists the Director in the daily operation of the respective unit(s)/department. They provide direct communication with the Director and/or House Supervisor of unanticipated patient care events and/or risk management activities within patient care unit(s); Utilizes nursing personnel effectively, assisting with required scheduling, staffing and assignments; Provides direction, supervision and evaluation of staff and/or staff education as necessary; Assists with performance evaluations, progressive discipline of staff and other related HR activities as needed; Assesses supplies and equipment availability, ensures their proper use and functionality and assists in the daily maintenance of par levels; Collaborates with other department managers/supervisors to ensure smooth coordination of services to patients; enhanced patient flow within the facility and efficient admission/discharge/transfer processes; Assesses patient care delivery and quality of care/documentation on a consistent basis; directs staff members to make immediate changes in the plan of care, as appropriate to ensure patient safety and adherence to regulatory guidelines, hospital policies, procedures, protocols and/or clinical pathways and notifies Department Director, House Supervisor and/or Medical Staff as appropriate utilizing the chain of command. Interviews patients/families on admission and during rounds to enhance positive patient experiences, provide comprehensive orientation to the patient care unit and increase patient/family awareness on how to access services and/or the charge nurse, if necessary. The Charge Nurse may perform direct patient care within scope of practice and clinical competency to ensure patient safety and patient/nurse ratios; they shall be temporarily relieved of Charge Nurse duties during such times by Director/designee and shall document details of same on patient care assignment record.
The Registered Nurse is responsible for the delivery of safe patient care utilizing the nursing process of assessment, planning, implementation and evaluation. Provides direct patient care within the scope of practice. The Registered Nurse also directs and guides patient/family teaching and activities of other nursing personnel while maintaining standards of professional nursing care in Telemetry. The Registered Nurse is directly responsible and accountable for the care given to his/her patients in the Emergency Department. They communicate with the physician about the changes in the patient’s clinical condition including results of the diagnostic studies and symptomatology. Is capable of responding quickly and accurately to changes in the condition and/or response to treatment. Is knowledgeable about EMTALA regulations and reporting of child/adult abuse to appropriate agencies and Hospital Social Worker. Maintains patient privacy and confidentiality.
The CNA in the Telemetry Department is a certified assistive person who assists with activities of daily living, provides basic nursing care to non-critical patients and assists in maintenance of a safe environment under the direction and supervision of the Registered Nurse in charge of the team and/or unit.
Under the general direction of the physician (Cardiologist/Radiologist), will assist by scrubbing procedures or monitoring physiologic and hemodynamic data, as related to diagnostic and/or therapeutic procedures performed in the cardiovascular lab. Ensures procedure room is adequately prepared for the procedure. Monitors par level of all instruments and supplies. Participates in departmental staff meetings and performance improvement activities and the training of new staff. Assists in all aspects of invasive and noninvasive cardiac procedures
The CNA in the Telemetry Department is a certified assistive person who assists with activities of daily living, provides basic nursing care to non-critical patients and assists in maintenance of a safe environment under the direction and supervision of the Registered Nurse in charge of the team and/or unit.
Under the general direction of the physician (Cardiologist/Radiologist), will assist by scrubbing procedures or monitoring physiologic and hemodynamic data, as related to diagnostic and/or therapeutic procedures performed in the cardiovascular lab. Certified to operate fluoro/pan with Fluoro CA license addendum. Ensures procedure room is adequately prepared for the procedure. Monitors par level of all instruments and supplies. Participates in departmental staff meetings and performance improvement activities and the training of new staff. Assists in all aspects of invasive and noninvasive cardiac procedures
The CNA in the Telemetry Department is a certified assistive person who assists with activities of daily living, provides basic nursing care to non-critical patients and assists in maintenance of a safe environment under the direction and supervision of the Registered Nurse in charge of the team and/or unit.
The CNA in the Telemetry Department is a certified assistive person who assists with activities of daily living, provides basic nursing care to non-critical patients and assists in maintenance of a safe environment under the direction and supervision of the Registered Nurse in charge of the team and/or unit.
The Monitor Tech is an unlicensed person who performs indirect care in the department setting. Monitors cardiac rhythms via direct cardiac monitors. Meets the communication needs of the department. Transcribes physician orders in the absence of CPOE and EMR clinical documentation system. Verifies that lab tests and radiology tests have been ordered and done. Prepares and complies records in the Emergency Department. Orders supplies for the unit and prepares and completes each patient's chart for necessary forms needed on a daily basis. Able to assist nursing staff with indirect patient care duties as long as the activity does not distract from primary responsibility for dysrhythmia monitoring.
Staff RN is directly accountable to the OR Charge Nurse and the Director of Surgical Services, and indirectly to the House Supervisor. The Registered Nurse is responsible for the delivery of direct and indirect patient care in the peri-operative setting through the nursing process of assessment, planning, implementation, and evaluation for neonates, pediatrics, adolescents, adults and older adults. The Registered Nurse coordinates the care of the patient with the surgeon and anesthesiologist, directs and guides the OR Technician and other personnel while maintaining standards of professional nursing. Works with other departments to provide a continuum of care and co-workers to provide continuous, quality patient care, efficient patient flow and unit maintenance and organization. Responsible for adherence to regulations, standards and hospital or unit policies and procedures. Responsible for participation in Performance Improvement activities, unit meetings and in-services. Acts as a resource for other personnel as appropriate.
Provides direct patient care to adult and geriatric patient populations. Addresses the psychosocial, physical and general aspects of care related to the surgical environment. Communicates with physician continuously and as needed about patient condition. Assists with the maintenance of equipment and inventory. Assesses procedure room or equipment functioning and readiness. Obtains supplies for individual cases and ensures all appropriate needs of the Cardiovascular Laboratory team are met. Monitors physiologic and hemodynamic data, as related to diagnostic and/or therapeutic procedures performed in the cardiovascular lab. Monitors and records patients condition continuously while in the Cardiovascular lab. Participates in performance improvement and continuous quality improvement activities.
The Clinical Supervisor supports administrative responsibility for the department service functions and works collaboratively with the unit Director and/or Manager. In the absence of the unit Director and/or Manager, the Clinical Supervisor may assume the administrative scope of the unit assigned. Develops and implements departmental plans, including performance improvement activities and compliance with current federal and/or state regulations. The Clinical Supervisor prepares, conducts and/or oversees department(s) orientation and training of personnel. Communicates with staff, physicians, and administration both written and verbally. The Clinical Supervisor is responsible and accountable for the quality of staff and functions during their shift. Assists the Department Director in the daily operation of the unit, directing, supervising, and evaluating personnel, ensuring the proper use of time, equipment, and staff. Ensure the efficient functions of the department. Performs direct patient care, only as needed, within the scope practice. Continually assess care and direct staff to make immediate changes in the plan of care.
The Clinical Supervisor supports administrative responsibility for the department service functions and works collaboratively with the unit Director and/or Manager. In the absence of the unit Director and/or Manager, the Clinical Supervisor may assume the administrative scope of the unit assigned. Develops and implements departmental plans, including performance improvement activities and compliance with current federal and/or state regulations. The Clinical Supervisor prepares, conducts and/or oversees department(s) orientation and training of personnel. Communicates with staff, physicians, and administration both written and verbally. The Clinical Supervisor is responsible and accountable for the quality of staff and functions during their shift. Assists the Department Director in the daily operation of the unit, directing, supervising, and evaluating personnel, ensuring the proper use of time, equipment, and staff. Ensure the efficient functions of the department. Performs direct patient care, only as needed, within the scope practice. Continually assess care and direct staff to make immediate changes in the plan of care.
The Emergency Department (ED) Charge Nurse is responsible and accountable to the Department Director for the quality of nursing staff and the delivery of patient care during their shift and assists the Director in the daily operation of the respective unit(s)/department. They provide direct communication with the Director and/or House Supervisor of unanticipated patient care events and/or risk management activities within patient care unit(s); Utilizes nursing personnel effectively, assisting with required scheduling, staffing and assignments; Provides direction, supervision and evaluation of staff and/or staff education as necessary; Assists with performance evaluations, progressive discipline of staff and other related HR activities as needed; Assesses supplies and equipment availability, ensures their proper use and functionality and assists in the daily maintenance of par levels; Collaborates with other department managers/supervisors to ensure smooth coordination of services to patients; enhanced patient flow within the facility and efficient admission/discharge/transfer processes; Assesses patient care delivery and quality of care/documentation on a consistent basis; directs staff members to make immediate changes in the plan of care, as appropriate to ensure patient safety and adherence to regulatory guidelines, hospital policies, procedures, protocols and/or clinical pathways and notifies Department Director, House Supervisor and/or Medical Staff as appropriate utilizing the chain of command. Interviews patients/families on admission and during rounds to enhance positive patient experiences, provide comprehensive orientation to the patient care unit and increase patient/family awareness on how to access services and/or the charge nurse, if necessary. The Charge Nurse may perform direct patient care within scope of practice and clinical competency to ensure patient safety and patient/nurse ratios; they shall be temporarily relieved of Charge Nurse duties during such times by Director/designee and shall document details of same on patient care assignment record.
Under the general direction of the physician (Cardiologist/Radiologist), will assist by scrubbing procedures or monitoring physiologic and hemodynamic data, as related to diagnostic and/or therapeutic procedures performed in the cardiovascular lab. Ensures procedure room is adequately prepared for the procedure. Monitors par level of all instruments and supplies. Participates in departmental staff meetings and performance improvement activities and the training of new staff. Assists in all aspects of invasive and noninvasive cardiac procedures.
Performs Diagnostic Radiographic, Cat Scan, Mammography, Bone Density, Ultra Sound or Special Procedures according to department protocols. Functions as the first line interface with customers and is successful in the accomplishment of their imaging needs. Participates in PI/ QC activities. Assists in Maintaining Performance Improvement Program. Oversees radiology area and/or staff in Manager's / Director's absence. Maintains department supplies. Promotes teamwork and good customer service. . Does scheduling for assigned sub departments and maintains supplies and equipment for assigned sub department. Responsible for Processing and transmission of Images to PACS.
The Emergency Department (ED) Charge Nurse is responsible and accountable to the Department Director for the quality of nursing staff and the delivery of patient care during their shift and assists the Director in the daily operation of the respective unit(s)/department. They provide direct communication with the Director and/or House Supervisor of unanticipated patient care events and/or risk management activities within patient care unit(s); Utilizes nursing personnel effectively, assisting with required scheduling, staffing and assignments; Provides direction, supervision and evaluation of staff and/or staff education as necessary; Assists with performance evaluations, progressive discipline of staff and other related HR activities as needed; Assesses supplies and equipment availability, ensures their proper use and functionality and assists in the daily maintenance of par levels; Collaborates with other department managers/supervisors to ensure smooth coordination of services to patients; enhanced patient flow within the facility and efficient admission/discharge/transfer processes; Assesses patient care delivery and quality of care/documentation on a consistent basis; directs staff members to make immediate changes in the plan of care, as appropriate to ensure patient safety and adherence to regulatory guidelines, hospital policies, procedures, protocols and/or clinical pathways and notifies Department Director, House Supervisor and/or Medical Staff as appropriate utilizing the chain of command. Interviews patients/families on admission and during rounds to enhance positive patient experiences, provide comprehensive orientation to the patient care unit and increase patient/family awareness on how to access services and/or the charge nurse, if necessary. The Charge Nurse may perform direct patient care within scope of practice and clinical competency to ensure patient safety and patient/nurse ratios; they shall be temporarily relieved of Charge Nurse duties during such times by Director/designee and shall document details of same on patient care assignment record.
The Clinical Supervisor supports administrative responsibility for the department service functions and works collaboratively with the unit Director and/or Manager. In the absence of the unit Director and/or Manager, the Clinical Supervisor may assume the administrative scope of the unit assigned. Develops and implements departmental plans, including performance improvement activities and compliance with current federal and/or state regulations. The Clinical Supervisor prepares, conducts and/or oversees department(s) orientation and training of personnel. Communicates with staff, physicians, and administration both written and verbally. The Clinical Supervisor is responsible and accountable for the quality of staff and functions during their shift. Assists the Department Director in the daily operation of the unit, directing, supervising, and evaluating personnel, ensuring the proper use of time, equipment, and staff. Ensure the efficient functions of the department. Performs direct patient care, only as needed, within the scope practice. Continually assess care and direct staff to make immediate changes in the plan of care.